cornerstone community application forms

application pack

Use this pack to apply for the following courses:

certificate III in christian studiesnational course code 91530nsw

certificate IV in christian studiesnational course code 91529nsw

diploma of christian studiesnational course code 91528nsw

advanced diploma of christian studiesnational course code 91527nsw

Cornerstone Community is a Registered Training Organisation offering these accredited courses as nationally recognised training. Enrolment in these courses is only open to applicants in Australia.

National RTO code 7056ABN 49 066 809 612

certificate III in christian studies (91530nsw)certificate IV in christian studies (91529nsw)

diploma of christian studies (91528nsw)advanced diploma of christian studies (91527nsw)

application pack

overview

To apply for training at Cornerstone Community, you must read the Prospectus carefully. It contains all the relevant information about the organisation and training courses.

After reading the Prospectus you should then complete the ‘Course Application’.

For those who have not enrolled previously in a course with Cornerstone Community:

We have included a ‘Student Application Medical Form’ which is to be completed by yourself and your doctor, and returned with this form.

There are also three ‘Reference Forms’ for you to pass on to your pastor, your employer (current or recent) and a teacher who knows you well (if possible).

Ask them to return those completed references directly to Cornerstone’s Registrar.

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abn 49 066 809 612 1 july 2011 © cornerstone community



application pack

course application PERSONAL DETAILS (as recorded on your birth certificate / driver's licence)

Surname / Family Name:

Personal / Given Names:

Date of Birth:

Gender: ¨ Male ¨ Female Date of Birth:

CURRENT ADDRESS

Postal Address:

Suburb & Postcode:

Country: (of current residence)

Country of Origin: (if different to above)

Phone number: Email:

FAMILY

Status: ¨ Single ¨ Engaged ¨ Married ¨ Widowed ¨Separated/Divorced

Will you be accompanied by your partner? YES ¨ NO ¨ Name:

Will you bring any children? YES ¨ NO ¨ ( ) ( ) ( ) ( )

( ) ( ) ( ) ( )Child's Name Sex DOB Child's Name Sex DOB

NEXT OF KIN Name:

Address:

Phone number:

Email:

Relationship to applicant (not husband or wife):

COMMITMENTS Do you have any commitments which may affect your arrival or involvement in the community or course? These may include:

¨ Traineeship or Apprenticeship to complete ¨ Course of study to complete

¨ A debt to a bank or finance company ¨ I owe someone money

¨ A commitment to an employer ¨ Another commitment

Give any relevant details:

CHURCH I have been attending for years.

Pastor's Details: Name: Phone:

Address:

If attending a church, do you have the pastor's support in coming to Cornerstone? YES ¨ NO ¨

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Attach a clearpassport-sizecolour photo

(enclose a second copy for your student card)

YOUR ‘STORY’ To make us aware of your background, goals and motivations for this course, please write a short introduction about yourself and describe what you hope to get out of the course on a separate sheet of paper.



application pack

PREVIOUS EDUCATION & TRAINING

High School: Grade completed in the year .

Tertiary or Trade Qualifications:

Work Experience:

Tax File Number: Current drivers licence? YES ¨ NO ¨ Class:

Previous involvement with Cornerstone Community? YES ¨ NO ¨Details:

PROFICIENCY WITH ENGLISH

¨ My first language is English ¨ I find it difficult to understand spoken English

¨ If not English; it is ¨ I find it difficult to understand written English

HOW DID YOU FIRST FIND OUT ABOUT CORNERSTONE COMMUNITY?

I visited ¨ Told by a student ¨ At church: ¨ Contacted by a Team ¨Newsletter¨ On the web-site ¨ At an event: ¨ Other: ¨

Who referred you to Cornerstone?

WHAT MOST INFLUENCES YOU TO COME TO CORNERSTONE?

Parent ¨ Going to a muster ¨ Meeting Cornerstone staff ¨ Info at a missions conference ¨Minister ¨ Mini-school/Camp ¨ Visiting a training centre ¨ Presentation at a school ¨Friends ¨ Website/leaflet ¨ Visiting a mission team ¨ Other: ¨

ENROLMENT

I wish to enrol in: ¨ Certificate III in Christian Studies (91530NSW): 6 months

¨ Certificate IV in Christian Studies (91529NSW): 1 year

¨ Diploma of Christian Studies (91528NSW): 1 years

¨ Advanced Diploma of Christian Studies (91527NSW): 1 year

Notes: 1. The Certificate III is usually offered as a 'nested' course within the Certificate IV unless we have enough applicants for a stand-

alone course. 2. Enrolment in the Diploma usually requires prior completion of the Certificate IV (or equivalent training elsewhere).3. Enrolment in the Advanced Diploma usually requires prior completion of the Diploma first (or equivalent training elsewhere).

TRAINING CENTRE: For enrolment in the Certificate III or Certificate IV, indicate your preferred training centres by placing the numbers 1-3 below.

¨ BROKEN HILL CENTRE ¨ CANOWINDRA CENTRE ¨ SWAN HILL CENTRE

Enrolment in the Diploma is only offered through the Team Studies Training Centre.

Enrolment in the Advanced Diploma is only offered at the Burrabadine Training Centre.

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application pack

Fees & Scholarships

The information you provide in this section is important for our planning for the coming year. You should read the section on “Fees & Scholarships” if you have any questions.

Calculate your annual cornerstone fees (including accommodation & food).

For an individual enrolled full-time in the course: $19000 If you have a partner with you (and not enrolled full-time in the course): add $10000 For each child who will accompany you: add $3000

Total annual Cornerstone fees:

Less the basic scholarship: subtract $13500

Balance of annual Cornerstone fees owing:

Indicate below which options apply for you.

¨ I will be applying to Centrelink for study benefits.I intend to pay the full balance of annual Cornerstone fees from those benefits.

¨ Centrelink has confirmed that I am eligible for only % of study benefits. I will pay the same percentage of fees owing from those benefits.I request a supplementary scholarship to cover the remaining balance of annual Cornerstone fees.

¨ I am not eligible for Austudy / Youth Allowance study benefits.

Have you confirmed this with Centrelink? (If not, please do so by contacting your local office)

Reason for ineligibility:

I request a supplementary scholarship to cover the balance of annual Cornerstone fees.

¨ I / We receive family benefits from Centrelink because we have children. From this income, we expect to contribute an amount towards the balance of fees every fortnight of $ I / We request a supplementary scholarship to cover the balance of annual Cornerstone fees.

Sign below after completing this application.

Signature: Date:

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Return this completed application including your 'story' to:

THE REGISTRARCORNERSTONE COMMUNITYPO BOX 1151 DUBBO NSW 2830AUSTRALIA



application pack

Student Application Medical FormReturn with your application to THE REGISTRAR, P.O. Box 1151 Dubbo NSW 2830.

Applicant’s Personal Details

Surname / Family Name: Personal / Given Name:

Postal Address: Suburb & Postcode:

Date of Birth: Gender: ¨ Male ¨ Female Medicare Number:

Cornerstone functions in small close-knit communities, and at times in more remote parts of the Australian Outback. There are doctors in nearby towns, but access is sometimes slow. We require that all students have a complete medical check-up as well as tests for infectious diseases that could have been contracted from contact with other persons or the environment before commencing training. This is to establish present physical and mental health. The work component of the course may involve physically taxing labour. Please send this medical report to the Registrar at the address shown on the top of this form.

The following information is requested to ensure that we are able to provide you with the best context for your training with Cornerstone. This information will never be made available to any person other than the relevant staff directly responsible for your enrolment and training.

To your knowledge have you ever:

Contracted an infectious disease / diseases such as HEPATITIS or AIDS? ¨ Yes ¨ No

Details

Suffered from chronic allergies; a post -viral / fatigue syndrome; chronic back injuries? ¨ Yes ¨ No

Details

Undergone psychiatric treatment or counselling OR been a patient in a psychiatric ward ¨ Yes ¨ No OR had a significant personality / emotional / mental / mood disorder OR made an attempt to take your own life?

Details

Do you have any drug dependencies (such as alcohol, nicotine, marijuana, heroin or others)? ¨ Yes ¨ No

Details

Do you take continual/frequent medication for a particular illness (eg. epilepsy, asthma)? ¨ Yes ¨ No

Details

Do you have any allergies to any medication? ¨ Yes ¨ No

Details

Do you have any dietary restrictions? ¨ Yes ¨ No

Details

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application pack

Do you expect to have any MEDICAL or DENTAL operations / treatments in the next two years? ¨ Yes ¨ No

Details

Have you had your appendix removed? ¨ Yes ¨ No

Is there any other information which may be relevant ? ¨ Yes ¨ No

Details

I hereby declare the above information to be accurate and complete and give permission for this medical practitioner and practice to disclose any medical information deemed relevant.

Applicant's signature: Date:

To be completed by your Medical Practitioner

How long have you known this patient ?

Having reviewed the above are you aware of any further information which may be relevant ?

Please detail any further investigations you consider desirable (Please forward the results of these with this form):

Practitioner’s Details:

Name (in block letters):

Address:

Phone number: Email:

Practi t ioner’s signature: Date:

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The applicant is to return this completed medical reference with their application to:




application pack

Pastor’s Reference FormReturn to THE REGISTRAR, P.O. Box 1151 Dubbo NSW 2830.

Dear Referee

You are being asked to fill out this form by the applicant mentioned below who is applying to join Cornerstone Community and enrol in a residential training course. Cornerstone is an Australian Christian community which trains people through courses and personal discipleship, building Christian character, Biblical understanding and skills for Christian mission as a way of life. To assist us in maximising the benefit of the training for this applicant, please answer the following questions as honestly as possible. When you have completed this reference, return this form to me directly. Thank you for your assistance.

With you in serving Christ,

The Registrar.




Pastor’s Details

Name: Phone:

Address:

Name of Church:

I have known the applicant for years / months.

About the Applicant

Involvement in Church:

Involvement in Local Community:

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application pack

Particular Gifts / Talents:

Other Areas of Strength:

Areas Needing Growth / Change:

General Attitude:

Teachability:

Initiative:

Reliability:

Interpersonal Relationships:

General Comments:

Pastor / Leader's Signature: Date:

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Please return this reference by post directly to:




application pack

Employer’s Reference FormReturn to THE REGISTRAR, P.O. Box 1151 Dubbo NSW 2830.

Dear Employer

You are being asked to fill out this form by the applicant mentioned below who is applying to join Cornerstone Community and enrol in a residential training course. Cornerstone is an Australian Christian community which provides accredited training courses. To assist us in maximising the benefit of the training for this applicant, please answer the following questions as honestly as possible. When you have completed this reference, return this form to me directly. Thank you for your assistance.

Yours sincerely

The Registrar.




Employer’s Details

Name: Phone:

Position / Title:

Company / Business:

The applicant was employed here from to (dates).

The positions / roles held by the applicant included:

About the Applicant

General attitude at work:

Effort in the workplace:

Promptness:

Appearance:

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abn 49 066 809 612 1 march 2011 © cornerstone community inc



application pack

Initiative:

Willingness to follow instructions:

Safety consciousness:

Care with equipment:

Responsibility with money:

Ability to complete tasks:

Motivation:

Reliability & responsibility:

Interpersonal relationships:

General Comments:

Employer's Signature: Date:

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abn 49 066 809 612 1 march 2011 © cornerstone community inc





application pack

Teacher’s Reference FormReturn to THE REGISTRAR, P.O. Box 1151 Dubbo NSW 2830.

Dear Referee

You are being asked to fill out this form by the applicant mentioned below who is applying to join Cornerstone Community and enrol in a residential training course. Cornerstone is an Australian Christian community which provides accredited training courses. To assist us in maximising the benefit of the training for this applicant, please answer the following questions as honestly as possible. When you have completed this reference, return this form to me directly. Thank you for your assistance.

Yours sincerely

The Registrar.




Teacher’s Details

Name: Phone:

School:

I have known the applicant for years / months.

About the Applicant

Teachability:

Application of knowledge:

Oral Communication Skills:

Written Communication Skills:

Listening Skills:

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application pack

Motivation & Initiative:

Personal Organisation:

Intellectual Ability:

Tick any that apply:

¨ Analytical ¨ Non-analytical ¨ Gifted in

¨ Accepts new ideas ¨ Struggles to learn ¨ Creative ¨ Inflexible

Interpersonal Relationships:

General Comments:

Teacher's Signature: Date:

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cornerstone community application forms

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